EMT Chapter 25-MCIT-F3-2205 | Tension Takedown -Thoracostomy A-Z:  This course is specifically designed for EMTs working with thoracic Pneumothorax. This course deals with thoracic anatomy and pathophysiology, various assessments, pneumothorax recognition techniques. Also discusses EMT management and intervention techniques and care for special populations

The lessons covered are 

• Lesson 1: Thoracic Anatomy and Pathophysiology 
• Lesson 2: Assessment and Recognition Techniques 
• Lesson 3: EMT Management and Interventions 
• Lesson 4: Special Patient Populations 
• Lesson 5: Communication and Teamwork 

Excerpt from EMT Chapter 25-MCIT-F3-2205 | Tension Takedown -Thoracostomy A-Z

Let’s start with the simple pneumothorax before we progress to tension. A pneumothorax occurs when air enters the pleural space, disrupting that negative pressure system we discussed. This can happen from blunt force trauma that fractures ribs, which then tear the pleura, from penetrating injuries that create a direct pathway for air, or sometimes spontaneously when a bleb or weakened area of lung tissue ruptures.  

Once air enters this space, the affected portion of the lung collapses due to its elastic recoil. This decreases the patient’s functional lung capacity and respiratory efficiency. I’ve treated numerous patients with simple pneumothorax, and their presentations can vary widely – from mild shortness of breath to significant respiratory distress, depending on the size of the pneumothorax and the patient’s underlying lung function.  

What’s crucial for us to remember is that a simple pneumothorax can be relatively stable if there’s no ongoing air leak. However, if a mechanism allows air to enter but not exit the pleural space, it can progress to a tension pneumothorax, which we’ll discuss next. This progression is what makes continuous assessment so important.